Doctor, no: Medical procedures to avoid

By Matthew Heimer

Being proactive and being prudent aren’t always equivalent– especially for boomers dealing with the health-care system. Though there’s a panoply of tests and treatment options available to deal with almost any medical problem, many of those procedures entail financial costs and physical risks that can outweigh, or at least make you think twice about, their potential benefits.

Intuitive Surgical

More care than you need?

To help consumers protect themselves against overzealous care and be better-informed when planning a strategy with their doctors, the Choosing Wisely program, a partnership of several medical-specialty groups and the magazine Consumer Reports, has been developing a list of unnecessary or overused tests and treatments. MarketWatch’s Elizabeth O’Brien wrote about some of these procedures in December (see “Four Medical Tests You May Not Need”), and over the past couple of weeks, the organization has rolled out a few dozen more recommendations, including several of particular interest to folks over 50.

Some of the recommendations fall into the common-sense category. Do you suspect doctors overprescribe antibiotics? So do a growing number of doctors: The Choosing Wisely folks recommend against using them to treat most cases of sinusitis and bronchitis, since most of those ailments are caused by viruses, not bacteria. Similarly, the program argues that CT, PET and MRI scans are used far more often than necessary: Patients and doctors should avoid using such scans to screen for cancer in healthy people, for example, or as a first line of diagnostic defense for patients with sore throats and hoarseness, hearing loss or lower back pain. And echocardiograms before and during surgery – up until now, a routine and often-expensive test at most hospitals – should be jettisoned, the program recommends, except for patients who have a history of heart trouble.

Particularly eye-opening, especially for boomers who may be helping their ailing parents, is the advice from the American Geriatrics Society and the American Academy of Hospice and Palliative Medicine – which paints a picture of the elderly as troublingly over-medicated. Sleeping pills are overused for patients suffering from agitation or insomnia, the doctors say, as are medications for urinary tract infections and diabetes (older patients don’t need to control their blood sugar as closely as younger ones). Near the top of both societies’ “don’t” lists: The use of feeding tubes for patients with dementia.

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About Encore

Encore looks at the changing nature of retirement, from new rules and guidelines for financial security to the shifting identities, needs and priorities of people saving for and living in retirement. Our lead blogger is editor Matthew Heimer, and frequent contributors include editor Amy Hoak, writer Catey Hill, and MarketWatch columnists Elizabeth O’Brien, Robert Powell and Andrea Coombes. Encore also features regular commentary from The Wall Street Journal retirement columnists Glenn Ruffenach and Anne Tergesen and the Director of the Center for Retirement Research at Boston College, Alicia H. Munnell.